The United States is experiencing its largest population of aging seniors, approximately one in five Americans will be over the age of 65 by 2030, according to a 2013 Centers for Disease Control and Prevention (CDC). In addition to a longer life expectancy, there are roughly 10,000 Americans celebrating their 65th birthday, every day, between 2011 and 2030 (Pew Research Center, 2010). How does retirement and long-term care planning affect lesbian, gay, bisexual, and transgender (LGBT) seniors and their families? This is the first blog in a series about the unique health, economic, legal, spiritual, and social challenges LGBT seniors face when planning for quality and affordable long-term care.
Historically disadvantaged groups, including the LGBT community, are more likely to be living in poverty, and have higher levels of illness, disability, and premature death as compared to their heterosexual counterparts (National Institutes of Health, 2013 and CDC, 2013). Research suggests that LGBT people may not seek out health care or disclose their sexual orientation or gender identity to their health care providers due to real or perceived discrimination. This is particularly damaging for LGBT seniors who are more likely to need access to health care services due to age-related changes or increased incidence of diseases (National Institutes of Mental Health, 2013).
LGBT seniors are often single and estranged from their biological family and rely more on friends and their community members as their chosen families. When insurance and employment policies, hospitals and nursing homes, and state laws prioritize biological family members as the only parties able to make decisions about an individual’s health, it disenfranchises LGBT senior’s families of choice and same-sex partners. Louisiana State University Nursing Professor, Harlee Kutzen, M.N., ACRN, spoke to me about the importance of LGBT seniors planning for end of life care by identifying a close friend to be a medical surrogate before illness or placement in a long-term care facility occurs. Advanced planning is likely to ensure that you and your loved one’s wishes are followed, not those of an institution, be it a nursing home or hospital, or estranged family members.
Identifying local resources to aid you or your loved one in establishing a power of attorney or medical surrogacy may be needed. Local, grass roots organizations, such as the Louisiana-based Advocates for GLBT Elders (NOAGE), provide a model for organizing around LGBT senior issues. Jim Meadows, LMSW, and NOAGE Board Member, told me that the organization came about through a recognition that loneliness, due to social isolation, was a wide-spread problem among LGBT seniors living in New Orleans.
NOAGE is tackling many of the issues identified by national researchers as challenges for the LGBT senior population, including accessing competent health care providers and navigating legal hurdles in retirement. The organization is modeled on Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) and reaches out to the senior community through monthly coffee talks on relevant topics for seniors, such as health living and making friends outside the bar scene. NOAGE also offers free cultural competency training to health care professionals about working with LGBT seniors and is hosting a legal workshop for seniors, their families, and friends that addresses navigating state laws on medical power of attorney, living wills, and spousal benefits.
For more information on community organizing around LGBT seniors please listen to the following interview with NOAGE board members Jim Meadows and Jason Waguespack on 102.3 WHIV FM.
Non-governmental, national advocacy organizations, such as SAGE and the National Resource Center on LGBT Aging, offer training and resources for issues important to LGBT seniors and their families. These topics include information on Medicaid and long-term care, transgender aging, and social security. SAGE also has links to local organizations who advocate for and provide resources to LGBT seniors. Please find more information about these organizations below:
Centers for Disease Control and Prevention, 2013, “The State of Aging and Health in America 2013”, http://www.cdc.gov/aging/help/dph-aging/state-aging-health.html
Pew Research, 2010, “Baby Boomers Retire”, http://pewresearch.org/databank/dailynumber/?NumberID=1150
National Institutes of Health, 2013, “Health Disparities among Lesbian, Gay, and Bisexual Older Adults:
Results From a Population-Based Study”, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770805/pdf/AJPH.2012.301110.pdf
SAGE and MAP, “Improving Lives of LGBT Older Adults”, 2010, http://www.lgbtmap.org/file/improving-the-lives-of-lgbt-older-adults.pdf